Liver transplant rejection: value of the resistive index in Doppler US of hepatic arteries

The authors prospectively evaluated the accuracy of the resistive index (RI) in Doppler ultrasound (US) for the detection of the increased vascular resistance that theoretically occurs with acute liver transplant rejection. RIs were calculated for the proximal hepatic artery and a more distal hepatic artery branch in 67 liver transplant recipients. Biopsies were performed within 24 hours of transplantation, with no intervening therapy. Examination of biopsy specimens by a single pathologist revealed findings of no, minimal, or moderate to severe rejection. RIs in hepatic arteries showed no significant differences among the three pathologic groups. No correlation was found between the RI and improved or worsened rejection in 11 patients who underwent biopsy and US more than once. RIs in hepatic arteries are of no value in the prediction of liver transplant rejection.     

V̇ max and nutritional status in Urban Colombian girls and women

Maximal oxygen consumption (V? max, liters min^?1) was measured in 60 nutritionally normal and 74 marginally undernourished girls 6–16 years of age and 27 upper socioeconomic (UEC) women and 22 women living in economically deprived conditions (LEC) in Cali, Colombia. All girls were recruited from the LEC neighborhoods. Lower values for V? max (liters min^?1) in undernourished girls were replaced by a nutritionally normal status in adulthood in which V? max was not significantly different from that measured in UEC women. Physical condition varied from average to fair in the younger to older subjects compared to women from industrialized countries. When V? max is expressed as ml min^?1 kg^?1 of lean body mass (LBM), all age and group effects disappear, confirming regression analysis which demonstrated a close relationship (r² = 0.81) between V? max (liters min^?1) and LBM in which there were no significant differences between nutritional or socioeconomic groups. © 1994 Wiley-Liss, Inc.     

Frequency of human immunodeficiency virus (HIV) infection among contemporary anti-HIV-1 and anti-HIV-1/2 supplemental test- indeterminate blood donors. The Retrovirus Epidemiology Donor Study

Background: Follow-up studies from the mid-1980s showed that 1 to 5 percent of blood donors testing reactive in anti-human immunodeficiency virus type 1 (HIV-1) enzyme immunoassay (EIA) and testing indeterminate in Western blot were infected with HIV-1 and were in the process of seroconverting. The present study was conducted to establish the rate of HIV infection among contemporary anti-HIV-1/HIV type 2 (HIV-2) EIA- reactive, Western blot-indeterminate donors. Study Design and Methods: Donations (n = 607) with indeterminate HIV supplemental test results were identified by screening 3,021,342 donations given from November 1990 through August 1993 at five participating blood centers. Consenting donors were enrolled and samples taken 4 to 8 weeks after donation. Follow-up sera were tested by EIA and Western blot for anti- HIV-1 seroconversion and by type-specific peptide assays for antibodies to HIV-2 and HIV-1 subtype O. Peripheral blood mononuclear cells and/or plasma from the follow-up samples were tested for HIV-1 DNA and/or RNA by polymerase chain reaction. The rate of HIV-1 infection among Western blot-indeterminate donors was also estimated by multiplying the incidence rate of HIV-1 seroconversion in this donor population by the estimated duration of the EIA-reactive and Western blot-indeterminate window during seroconversion (8.5 days). Results: Supplemental test- indeterminate donors (n = 355) enrolled a median of 38 days after donation; 265 (75%) of these donors were identified as indeterminate after an anti-HIV-1/2 EIA-reactive donation. Enrolled and non-enrolled donors had similar distributions of demographic characteristics and band patterns. Follow-up samples from all 355 donors tested negative for HIV-1 in polymerase chain reaction. Follow-up sera tested Western blot-negative in 54 cases (15%) and Western blot-indeterminate in 299 (84%). Two follow-up sera (0.6%) were interpreted, according to manufacturer's package insert criteria, as Western blot positive with p24 and gp41 bands and/or gp120/160 bands; however, paired testing of index and follow-up sera from these two cases showed identical Western blot and EIA reactivity, and polymerase chain reaction was negative for HIV RNA and DNA, which ruled out HIV infection. The absence of HIV infection in 355 Western blot-indeterminate donors was consistent with our incidence-based model analysis, which yielded an estimate of one HIV-1 infection for every 215 Western blot-indeterminate donations (95% CI, 1/39-1/8333). Conclusion: Contemporary blood donors classified as indeterminate in supplemental HIV testing are infrequently infected with HIV. Donors whose follow-up samples test negative in anti-HIV-1/2 EIAs and negative or persistently indeterminate in Western blots should be considered eligible for reinstatement.     

Allergic contact dermatitis from exposure to Grevillea robusta in New Zealand

There are a number of reports in the literature of allergic contact dermatitis as a result of exposure to the sawdust and plant parts of Grevillea robusta . While this tree is prevalent in New Zealand, there seems to have been no previous published accounts of contact dermatitis, although anecdotal evidence indicates that such cases may be common. Two brief case reports are provided regarding severe phytodermatitis to G. robusta among professional arborists in New Zealand. As with other common plants capable of inducing allergic contact dermatitis, greater awareness among arborists, orchardists, forestry workers, gardeners, and health professionals will likely result in a reduction of cases.     

Limited motor performance and minor neurological dysfunction at school age

Aim: To investigate the relationship between motor performance and minor neurological dysfunction (MND) at school age. Methods: Two hundred and fifty‐three children (158 boys, 95 girls; mean age 8 years and 7 months) of whom 167 children received mainstream education and 86 children special education were neurologically examined according to Touwen. Special attention was paid to the severity of MND (simple or complex form) and type of dysfunction. Motor performance was assessed with the Movement Assessment Battery for Children (MABC), a parental questionnaire (Developmental Coordination Disorder Questionnaire; DCD‐Q) and a teacher’s questionnaire (Motor Observation Questionnaire for Teachers; MOQ‐T). Results: Total scores of MABC, DCD‐Q and MOQ‐T were strongly related to the severity of MND and to dysfunctional coordination and fine manipulation. Mild dysfunction in posture and muscle tone was only weakly related to limited motor performance. Children with a MABC score < 5th percentile showed significantly more often complex MND than children with scores between the 5th and 15th percentile or >15th percentile (54% vs 17% and 10%). Conclusion: Limited motor performance is related to the severity and type of MND. Coordination problems and fine manipulative disability are strongly related to poor motor performance, mild dysfunctions of posture and muscle tone to a lesser extent.